5.37 Hospital/Medical Insurance

Full time employees are eligible to participate in the North Carolina State Health Plan ("the Plan") in accordance with guidelines established by the Plan. The cost of individual employee coverage is paid by CVCC as authorized each year by the North Carolina General Assembly. The cost of coverage for spouses and other family members must be paid by the employee. Further information may be obtained from the Personnel Office or from the State Health Plan website.

5.37A Affordable Care Act

In accordance with the Affordable Care Act (ACA), beginning on January 1, 2015, North Carolina agencies must offer health insurance coverage for employees who qualify under the ACA guidelines, which includes employees who average 30 hours per week or 130 hours per month based on the agency's guidelines or procedures. If the employer fails to make offers of insurance, the employer faces financial penalties. In North Carolina, all employees who qualify for an offer of insurance under the ACA definition are entitled to insurance coverage (bronze level plan under the State Health Plan). The bronze plan was developed to provide minimum essential coverage, and to minimize the employer contribution in an administratively feasible manner.

Definitions:

Service hours: Each hour for which an employee is credited for the performance of services. For instructor positions, service hours include classroom instruction time, class preparation, course development, and other duties as assigned or required by the college.

The College has also elected to utilize the "bright line" or safe harbor approach which allows the College to determine average hours over a measurement period to determine eligibility.

Workload formula: Workload (loading) formula recognizes service contributions of all instructional positions and helps ensure equity in workload assignments. In the North Carolina Community College System, the formula for workload is a local college decision.

Break in service: A period of time for which an employee does not work. This could be semester breaks or other times the College is closed.

Standard/Initial Measurement period: The period of time for which an employee's hours are recorded and measured to determine average hours worked.

The college will utilize a 6 month measurement period.

For new hires, the employee will be evaluated from the first day of the month following the date of hire through six months. There will be some overlap at the six month period to allow the employee to become part of the regular cycle for the following measurement period.

Administrative period: The time after the Standard/Initial Measurement Period that it takes to enroll an eligible employee in the health plan.

The college will utilize a 2 month administrative period.

For new hires, administrative period will be 2 months after the initial measurement period has ended.

Stability period: The period of time after the Administrative Period for which health benefits are provided to eligible employees.

The college will utilize a 6 month stability period.

For new hires, administrative period will be 6 months after the measurement period and continue through the next regularly scheduled stability period.

Seasonal Employee: An employee who is employed on a temporary basis for a defined period of time, such as registration.

Independent Contract Employee: An individual who is contracted to perform a service for the college for which there is no employer/employee relationship; the college has the right to control or direct only the result of the work and not what will be done and how it will be done. These individuals would not be ACA eligible under the College's guidelines.

Temporary agency employee: An employee assigned to work at the college through a staffing firm. These individuals would not be ACA eligible under the College's guidelines.

Employment Structure and Health Plan Coverage Eligibility:

Regular Full-Time Employee - A position established in the budget as a regular, recurring position. Employment must be for nine or more months per fiscal calendar year and must be considered full-time weekly employment. Employee receives all employee benefits as published in this policy document.

Faculty

Staff

Regular Part-Time Employee - An employee who works between 20-25 service hours per week.

Adjunct - employed with a course-based contract per academic term with no expectation of recurring employment outside of the contracted hours

Staff – employed at will for the duties needed Health insurance is not offered. Between 20-25 hours per week, employees may participate in the health plan by paying the entire cost of coverage. If under 20 hours per week, employee cannot participate in the plan.

Temporary Full-Time Employee – A position established in the budget as a temporarily funded position. Employment period is established by grant funding and considered full-time weekly employment. Employee receives all employee benefits as provided by budget of the grant. Employee is not subject to Reduction in Force Policy, and has no expectancy of re-employment at CVCC.

Part-Time ACA Eligible Employee: An employee who works more than 30 hours per week for a measurement period. Health insurance will be offered during an administrative period for the duration of the stability period as described by the College. The employee would have to meet the eligibility requirements during future measurement periods to continue health insurance coverage. Employee must maintain employment throughout the stability period.

Note for Full-Time Temporary positions:

Coverage must be offered within 3 months, so the college needs to make a decision on the duration of the temporary assignment before the end of the 3 months period. If still employed during month 4, you must provide coverage.

Full-Time Temporary Positions

Category

Employment Category/Appointment Type

Eligibility Trigger

Eligibility Point

A

Regular Full Time Employee

Hire

Time of Hire

B

Regular Part Time Employee

Hire

Eligible at hire but must pay full cost of coverage if working between 20-25 hours

C

Temporary-Full Time

Employed more than 3 months

At time of hire

D

Part Time ACA Eligible Employee

After measurement period where employee averaged more than 30 hours per week.

Subsequent Stability Period assuming continued employment

*

Temporary Agency Staff

May be eligible for coverage through the temporary agency

**

Independent Contractor

No coverage eligibility

Measurement Period:

The measurement period for the college will be a six (6) month time period that will encompass at least one complete academic curriculum term.

The measurement period for any new hire will begin on the first day of the following month after employment (unless they begin on the first business day of the month). After the first six months, they will be on the regular schedule of all part time employees. There will be a period of overlap of the initial measurement period and the regular measurement period.

Administrative Period:

The administrative period for the college will be the two (2) month period following the measurement period for all employees.

Stability Period:

The stability period for the college will be the six (6) month time period immediately following the administrative period.

The stability period for any new hire will begin the month after the administrative period has ended and continue to the next regularly scheduled stability period. Therefore, an employee may be eligible for ACA benefits between 6 and 11 months based upon the hire date due to the overlap of the measurement period for new hires.

If an employee leaves the college's employment or is terminated, the ACA coverage would be terminated immediately. Otherwise, the employee would continue to have coverage until such time as the next measurement period declares the employee ineligible for ACA coverage.

ACA Coverage Periods

Periods

MEASUREMENT PERIOD

ADMINISTRATIVE PERIOD

STABILITY PERIOD

A)

JANUARY-JUNE

JULY and AUGUST

SEPTEMBER-FEBRUARY

B)

JULY-DECEMBER

JANUARY and FEBRUARY

MARCH-AUGUST

Define established breaks in service:

A break in service is a period of time for which an employee does not work due to college breaks or breaks within the semesters. These breaks may include, but are not limited to, semester breaks, summer break, spring break, and Christmas breaks. These breaks are not included in the calculation of hours for ACA eligibility.

If a time period of 26 weeks or greater occurs, then the employee would be considered a re-hire.

Opting Out procedures:

Any employee may choose to not accept coverage in the health plan. Employees should annually complete a form that acknowledges that they were offered coverage and chose not to accept the coverage. Opting out of coverage shall not be used as a reason to allow an employee to work additional hours. Once an employee opts out for the plan year, they cannot enroll again until the next annual enrollment.